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Diabetes 101

Diabetes is a disease where the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and lifestyle factors such as obesity and lack of exercise appear to play roles.

According to the American Diabetes Association, there are 23.6 million diabetic children and adults in the United States -- or 7.8 percent of the population who has diabetes. While an estimated 17.9 million have been diagnosed with diabetes, 5.7 million people are unaware that they have the disease.

Types of diabetes

There are several different types of diabetes. These are the most common:

--Type 1 diabetes: This results from the body's failure to produce insulin, the hormone that "unlocks" the cells of the body, allowing glucose to enter and fuel them. It is estimated that 5-10 percent of Americans diagnosed with diabetes have Type 1 diabetes.

--Type 2 diabetes: This is when the body fails to properly use insulin, combined with relative insulin deficiency. Most Americans who are diagnosed with diabetes have Type 2 diabetes.

-- Gestational diabetes: This form of diabetes occurs during a woman’s pregnancy. Immediately after pregnancy, the great majority of women with gestational diabetes will shed their diabetic condition and move on. However, 5-10 percent of women who have gestational diabetes will develop diabetes, usually Type 2.

-- Pre-diabetes:
This is a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of Type 2 diabetes. There are 57 million Americans who have pre-diabetes, in addition to the 23.6 million with diabetes.

One of the major issues with diabetes is that it often goes undiagnosed because many of its warning signs seem harmless. Recent studies indicate that early detection and treatment of diabetes can decrease the chance of developing complications of diabetes. These are the most frequent symptoms:

-- Frequent urination
-- Excessive thirst
-- Extreme hunger
-- Unusual weight loss
-- Increased fatigue
-- Irritability
-- Blurry vision


If you have any of these symptoms, your doctor can give you one of two tests -- a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). The American Diabetes Association recommends the FPG because it is easier, faster, and less expensive to perform.

With the FPG test, a fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes. A person with a fasting blood glucose level of 126 mg/dl or higher has diabetes.

In the OGTT test, a person's blood glucose level is measured after a fast and two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140 and 199 mg/dl, the person tested has pre-diabetes. If the two-hour blood glucose level is at 200 mg/dl or higher, the person tested has diabetes.

The American Diabetes Association also has a quick online risk test you can take.

The good news is that diabetes is treatable, especially if you’ve been diagnosed with pre-diabetes. The Diabetes Prevention Program (DPP) study shows that people with pre-diabetes can prevent the development of Type 2 diabetes by making changes in their diet and increasing their level of physical activity. They may even be able to return their blood glucose levels to the normal range.

While the DPP also showed that some medications may delay the development of diabetes, diet and exercise worked better. Just 30 minutes a day of moderate physical activity, coupled with a 5-10 percent reduction in body weight, produced a 58 percent reduction in diabetes.

For those with Type 2, sometimes diet and exercise will bring blood glucose levels down to the normal range. If not, there are several medicines that can be used.

People with Type 1 diabetes are not producing insulin, so the only thing they can do to bring blood glucose levels down is to take insulin shots.

Gestational diabetes hits women late in their pregnancies. Quick treatment is necessary to protect the health of the mother and the baby. That often includes special meals and physical exercises. Sometimes daily blood glucose testing and insulin injections are needed.

Complications from Type 1 and Type 2 diabetes are very serious, and can be severe. They include an increased risk of heart attack, stroke and other problems related to poor blood circulation. That also includes foot problems, which sometimes leads to amputation. Diabetes can also damage the kidneys, causing them to not work properly or to fail completely. Diabetes can cause eye problems that could lead to blindness. One of the most common problems is nerve damage, called diabetic neuropathy, affecting the nerves that run throughout the body.

While the exact cause of diabetes is unknown, researchers know genetics plays a role. But it’s not genetics alone – there has to be another trigger. Studies on identical twins (who have identical genes) show when one twin has Type 1 diabetes, the other gets the disease at most only half the time. When one twin has Type 2 diabetes, the other's risk is at most 3 in 4.

Lifestyle is crucial. Diabetics must eat smart, avoid weight gain, and get physical exercise every day.


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